Factors influencing the implementation of Global Polio Eradication Initiative in low- and middle-income countries: a qualitative evidence synthesis

Background: A country’s health system faces pressure when hit by an unexpected shock, such as what we observe in the midst of the coronavirus disease 2019 (COVID-19) pandemic. The concept of resilience is highly relevant in this context and is a prerequisite for a health system capable of withstanding future shocks. By exploring how the key dimensions of the resilient health system framework are applied, the present systematic review synthesizes the vital features of resilient health systems in low- and middle-income countries. The aim of this review is to ascertain the relevance of health system resilience in the context of a major shock, through better understanding its dimensions, uses and implications. Methods: The review uses the best-fit framework synthesis approach. An a priori conceptual framework was selected and a coding framework created. A systematic search identified 4284 unique citations from electronic databases and reports by non-governmental organisations, 12 of which met the inclusion criteria. Data were extracted and coded against the pre-existing themes. Themes outside of the a priori framework were collated to form a refined list of themes. Then, all twelve studies were revisited using the new list of themes in the context of each study. Results: Ten themes were generated from the analysis. Five confirmed the a priori conceptual framework that capture the dynamic attributes of a resilient system. Five new themes were identified as foundational for achieving resilience: realigned relationships, foresight and motivation as drivers, and emergency preparedness and change management as organisational mechanisms. Conclusion: The refined conceptual model shows how the themes inter-connect. The foundations of resilience appear to be critical especially in resource-constrained settings to unlock the dynamic attributes of resilience. This review prompts countries to consider building the foundations of resilience described here as a priority to better prepare for future shocks.

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Factors affecting the successful implementation of Global Polio Eradication Initiative (GPEI) in low- and middle-income countries

Journal of Global Health ◽

10.7189/jogh.10.010322 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Suleiman E Mshelia ◽

Chris Blackmore ◽

Rachel Archer ◽

Andrew Booth

Keyword(s):

Polio Eradication ◽

Successful Implementation ◽

Middle Income ◽

Factors Affecting ◽

Middle Income Countries ◽

Global Polio Eradication Initiative ◽

Low And Middle Income

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Factors influencing the migration intention of health professionals in low and middle income countries: Critical review with a theoretical model

Journal of Contemporary Medical Sciences ◽

10.22317/jcms.v6i6.897 ◽

2020 ◽

Vol 6 (6) ◽

Author(s):

Sara Hajian ◽

Shahram Yazdani ◽

MohammadPooyan Jadidfard ◽

MohammadHossein Khoshnevisan

Keyword(s):

Health Workers ◽

Final Decision ◽

Middle Income ◽

Poor Countries ◽

Middle Income Countries ◽

Medical Graduates ◽

Factors Influencing ◽

Decision To Stay ◽

Push And Pull ◽

Low And Middle Income

Objective Migration of healthcare workers could result in shortage of human resources and rising inequalities in service provision in resource poor countries. The aim of this review was to determine the factors influencing the migration decisions of medical and dental graduates migrating from low- and middle-income countries as well as introducing a practical model for health professional’s migration. Methods Google Scholar and PubMed were searched together with relevant journals for English studies from January 2005 to January 2020. The original studies which evaluated the motivational factors of dental and medical graduates migrating from low or middle income countries were included. The migration model was developed by investigating the factors and frameworks of selected studies. Results Twenty-five articles were met the inclusion criteria. Push and pull theory was the most popular way to describe the driving factors of migration. These factors were classified into three macro-, meso- and micro-level with eight key domains. Poor income, unfavorable socio-economic situation, political instability, lack of professional and educational opportunities together with family and personal concerns found as strong common reasons perpetuating migration. Conclusion Despite the fact that health workers migrate for different reasons, they follow a same route for decision to stay or leave their home countries. Un-fulfillment of expectations in mother land in addition to media reconstructed reality of life in foreign land can develop a positive attitude for better quality of life improvement after migration. Once individuals could overpass their national identity and barriers of migration, the final decision toward migration would be more feasible.

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